三叉神经痛患者三叉神经脑池段MR形态测量研究

发布时间：2018-07-26 13:55

【摘要】：目的 :通过对三叉神经痛(Trigeminal neuralgia,TN)患者及对照组进行三叉神经脑池段MR形态测量,研究TN患者患侧三叉神经脑池段形态结构的差别。方法:45例经临床诊断为TN的患者和45例健康志愿者作为对照组纳入本研究。所有受试对象采用GE 3.0T MR扫描,采用3D-TOF-SPGR及3D-FIESTA序列,分别以两侧三叉神经脑池段为中心进行轴位扫描。通过reformat软件对扫描图像进行后处理,测量三叉神经脑池段长度及冠状位、轴位、矢状位上三叉神经脑池段最大横截面积,三叉神经与脑桥夹角,三叉神经根岩尖处转角及血管压迫部位距三叉神经根部的距离,然后对测量结果进行统计分析,并根据两组序列上双侧三叉神经各形态学测量值的差异比做ROC曲线,评价两组序列各形态学测值对TN的诊断效能。以P0.05为具有统计学差异。结果:患侧三叉神经脑池段长度及冠状位、轴位、矢状位三叉神经脑池段最大横截面积均小于健侧及对照组(P0.05),而患侧三叉神经与脑桥夹角、三叉神经根岩尖处转角与健侧及对照组比较无显著差异(P0.05)。对照组的双侧三叉神经脑池段形态学测量结果差异均无统计学意义(P0.05),但对照组三叉神经脑池段长度及冠状位、轴位、矢状位三叉神经脑池段最大横截面积均大于患者健侧(P0.05),而三叉神经与脑桥夹角及三叉神经根岩尖处转角与健侧比较无差异(P0.05)。在两组序列各形态学测值的差异比中,SPGR序列上冠状位最大横截面积的差异比对TN诊断的准确度最高。TN患者患侧三叉神经血管压迫部位距根部约为(2.124±1.478)mm,84.4%的患者患侧血管压迫神经都发生在三叉神经脑池段近段。结论:三叉神经MR形态学测量能够更加直观的显示三叉神经形态学改变,增加了临床TN诊断的客观性,为TN的诊断提供了一种新的方法和思路。
[Abstract]:Objective: to study the morphological structure of trigeminal cistern in patients with Trigeminal neuralgia (TN) and control group. Methods 45 clinically diagnosed TN patients and 45 healthy volunteers were included as control group. All subjects were scanned by GE 3.0T Mr, 3D-TOF-SPGR and 3D-FIESTA sequences, respectively, using bilateral trigeminal cistern segment as the center of axial scanning. The length of the trigeminal cisterns, the coronal, axial and sagittal transection of the trigeminal cisterns and the angle between the trigeminal nerve and the pons were measured by reformat software. The angle of rotation at the apex of trigeminal nerve and the distance from the point of vascular compression to the root of trigeminal nerve were analyzed statistically. According to the differences of morphological measurements of the trigeminal nerve in the two groups of sequences, the ROC curve was made. To evaluate the diagnostic efficacy of morphological measurements for TN in two groups of sequences. P0.05 as a statistical difference. Results: the maximum cross sectional area of the trigeminal cisternal segment in the affected side was smaller than that in the healthy side and the control group (P0.05), while the angle between the trigeminal nerve and the pons in the affected side was smaller than that in the healthy side and the control group (P0.05). There was no significant difference in the angle of the apex of trigeminal nerve between the healthy side and the control group (P0.05). There was no significant difference in the morphology of the bilateral trigeminal cisterns in the control group (P0.05), but in the control group, the length of the trigeminal cistern segment and its coronal and axial position were not significantly different. The maximum cross sectional area of trigeminal cisternal segment in sagittal position was larger than that of healthy side (P0.05), while the angle between trigeminal nerve and pons and the angle of turning at the petrosal tip of trigeminal nerve had no difference from that of healthy side (P0.05). Comparison of the maximum coronal cross sectional area on the SPGR sequence in the two groups. The diagnosis accuracy of TN is the highest. The location of trigeminal nerve compression is about (2.124 卤1.478) mm ~ (4)% of the patients' blood from the root of the affected side of trigeminal nerve in the patients with TN. The canal compression nerve occurred in the proximal segment of the trigeminal cistern. Conclusion: Mr morphological measurement of trigeminal nerve can show the morphological changes of trigeminal nerve more intuitively, increase the objectivity of clinical TN diagnosis, and provide a new method and train of thought for TN diagnosis.
【作者单位】：中国医科大学附属第一医院放射科;荆州市第一人民医院放射科;
【分类号】：R445.2;R745.11

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